| 1. |
- Claesson, Ing-Marie, et al.
(författare)
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Consumer satisfaction with a weight-gain intervention programme for obese pregnant women
- 2008
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Ingår i: Midwifery. - : Elsevier. - 0266-6138 .- 1532-3099. ; 24:2, s. 163-167
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Tidskriftsartikel (refereegranskat)abstract
- Objective: to investigate women's attitudes and satisfaction with a weight-gain intervention programme during pregnancy.Design: exploratory, descriptive study. Data were collected via interviews.Setting: University hospital.Participants: 56 obese pregnant women who attended antenatal care at the University Hospital of Linkoping's obstetrical department and took part in an intervention programme aimed at reducing weight gain during pregnancy, between November 2003 and August 2004.Findings: the interviews comprised several questions concerning attitudes and opinions of the programme. Most of the women expressed positive experiences with the treatment and would attend the programme if they became pregnant again. Most of the women stated that they had changed their eating and exercise habits during pregnancy, and almost all of them had continued with these new habits. Even though the weight gain goal of a maximum 6.9 kg was reached by less than half of the participants, most of the women were satisfied with their weight gain. A total of 71.4% of the women participated in aqua aerobics classes. They stated that they were most satisfied with this form of exercise, and that it also was a good social experience.Key conclusions and implications for practice: a pregnant woman herself must be actively involved in setting her own goals to prevent excessive weight gain during pregnancy. Considerable effort and support must be placed on discussing strategies, pitfalls and risks. In order for the woman to maintain the change in attitude and habits, she must probably be given continuous feedback and reinforcement over the long term.
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| 2. |
- Claesson, Ing-Marie, et al.
(författare)
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Weight gain restriction during pregnancy is safe for both the mother and neonate
- 2009
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : John Wiley & Sons. - 0001-6349 .- 1600-0412. ; 88:10, s. 1158-1162
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to investigate whether pregnancy, delivery, and neonatal outcome among obese pregnant women who took part in an intervention study for weight restriction differed from a group of obese pregnant women attending regular antenatal care. The intervention group consisted of 155 obese pregnant women and 193 obese pregnant women who formed a control group. We found that a weight gain restriction of less than 7 kg during pregnancy is safe for both the mother and the neonate.
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| 3. |
- Claesson, Ing-Marie, 1953-, et al.
(författare)
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Weight gain restriction for obese pregnant women : A case-control intervention study
- 2008
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Ingår i: British Journal of Obstetrics and Gynecology. - : Wiley. - 1470-0328 .- 1471-0528. ; 115:1, s. 44-50
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To minimise obese women's total weight gain during pregnancy to less than 7 kg and to investigate the delivery and neonatal outcome. Design: A prospective case-control intervention study. Setting: Antenatal care clinics in the southeast region of Sweden. Population: One hundred fifty-five pregnant women in an index group and one hundred ninety-three women in a control group. Methods: An intervention programme with weekly motivational talks and aqua aerobic classes for obese pregnant women. Main outcome measures: Weight gain in kilograms, delivery and neonatal outcome. Results: The index group had a significantly lower weight gain during pregnancy compared with the control group (P < 0.001). The women in the index group weighed less at the postnatal check-up compared with the weight registered in early pregnancy (P < 0.001). The percentage of women in the index group who gained less than 7 kg was greater than that of women in the control group who gained less than 7 kg (P = 0.003). The percentage of nulliparous women in this group was greater than that in the control group (P = 0.018). In addition, the women in the index group had a significantly lower body mass index at the postnatal check-up, compared with the control group (P < 0.001). There were no differences between the index group and the control group regarding birthweight, gestational age and mode of delivery. Conclusion: The intervention programme was effective in controlling weight gain during pregnancy and did not affect delivery or neonatal outcome.
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| 4. |
- Moberg, Christina, et al.
(författare)
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De unga gör helt rätt när de stämmer staten
- 2022
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Ingår i: Aftonbladet. - 1103-9000.
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- 1 620 forskare och lärare i forskarvärlden: Vi ställer oss bakom Auroras klimatkrav
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| 5. |
- Axelsson, Daniel, 1974-
(författare)
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Postpartum infections; prevalence, associated obstetric factors and the role of vitamin D
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Postpartum infections are a major cause of maternal mortality and morbidity worldwide. Breast infection, endometritis, urinary tract infection and wound infections are the most common postpartum infections and together they affect almost 20% of women after childbirth. Some risk factors for postpartum infections, for example cesarean section, have been relatively well studied, but other presumable risk factors are yet to be confirmed.The proportion of pregnant women who are overweight or obese is increasing in most parts of the world. Increased maternal body mass index (BMI) is associated with maternal and infant morbidity. The association between overweight / obesity and postpartum infections is incompletely understood. Vitamin D deficiency has in epidemiological studies been shown to increase the risk of various infections. Furthermore, vitamin D is an important factor in the human immune system. Concomitantly, vitamin D supplementation seems protective against some types of infections. Whether vitamin D deficiency is a risk factor for postpartum infections has not been studied.Material and Methods: In a population-based observational study using questionnaires, the prevalences of postpartum wound infections, endometritis, urinary tract infections and mastitis in the southeast region of Sweden were estimated (Paper I). All women giving birth in the region during one year (n=11 124) were asked to participate. Papers II and III were cohort studies based on all deliveries in Sweden during eight years (2005-2012). Data sources were the Swedish Medical Birth Register, the Swedish National Patient Register and the Swedish Prescribed Drugs Register. In paper II all term deliveries were included (n=795 072). Risk factors for postpartum wound infections, endometritis and urinary tract infection were evaluated. Paper III included all deliveries (n=841 780) and examined the impact of BMI on the risk of postpartum wound infections, endometritis and breast abscess after different modes of delivery. Infections were defined as the presence of applicable ICD-10 codes. The Mantel-Haenszel technique was used to calculate adjusted odds ratios. In paper IV the association between vitamin D deficiency and overall postpartum infectious morbidity was analyzed. Serum samples from the Pregnancy Biobank in Linköping, drawn at the time of delivery, were used to determine concentrations of 25-hydroxyvitamin D in 1397 women. ICD-10 codes were extracted from the women’s medical records. The prevalence of vitamin D deficiency was calculated and adjusted odds ratios for postpartum infections were estimated with multivariable logistic regression analysis.Results: More than one out of ten women in southeast Sweden reported wound infections; endometritis, urinary tract infection or mastitis postpartum and 7.5% reported antibiotic treatment for infection. Cesarean section was the strongest risk factor for wound infection, followed by obstetric anal sphincter injuries and episiotomy. For endometritis, the strongest risk factors were anemia, manual placental removal and emergency cesarean section. Urinary tract infection was associated with anemia, instrumental vaginal delivery and emergency cesarean section. There was a dose-dependent increased risk of postpartum infection with higher BMI. For morbidly obese women the risk of infection was over 50% higher than for normal weight women. The risk of endometritis after normal vaginal delivery increased the higher the BMI, as did the risk of wound infection after cesarean section, regardless of the type of cesarean section. For breast abscess, there was an inverse association with BMI.Vitamin D deficiency was present among almost 60% of pregnant women at the time of delivery. No association between vitamin D deficiency and postpartum infections was found.Conclusions: Every tenth Swedish woman acquired an infection postpartum and three quarters of them received antibiotics for infection. Anemia was an important risk factor for postpartum infection, and the strongest risk factor for endometritis and urinary tract infection. Strong efforts should be made to reduce blood loss during and after childbirth. This thesis confirmed cesarean section as a major risk factor for postpartum infection, especially wound infection. The risk increased if the woman was overweight or obese, regardless of whether it was a planned or an emergency cesarean section.Vitamin D deficiency was common among Swedish pregnant women, but it was not found to be associated with postpartum infections.
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| 6. |
- Cedergren, Marie, 1963-, et al.
(författare)
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Chlorination byproducts and nitrate in drinking water and risk for congenital cardiac defects
- 2002
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Ingår i: Environmental Research. - : Elsevier BV. - 1096-0953 .- 0013-9351. ; 89:2, s. 124-130
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Tidskriftsartikel (refereegranskat)abstract
- Drinking water disinfection byproducts have been associated with an increased risk for congenital defects including cardiac defects. Using Swedish health registers linked to information on municipal drinking water composition, individual data on drinking water characteristics were obtained for 58,669 women. Among the infants born, 753 had a cardiac defect. The risk for a cardiac defect was determined for ground water versus surface water, for different chlorination procedures, and for trihalomethane and nitrate concentrations. Ground water was associated with an increased risk for cardiac defect when crude rates were analyzed but after suitable adjustments this excess rate was found to be determined by chlorination procedures including chlorine dioxide. Chlorine dioxide appears itself as an independent risk factor for cardiac defects (adjusted odds ratio 1.61 (95% CI 1.00-2.59)). The risk for cardiac defects increased with increasing trihalomethane concentrations (P = 0.0005). There was an indicated but statistically nonsignificant excess risk associated with nitrate concentration. The individual risk for congenital cardiac defect caused by chlorine dioxide and trihalomethanes is small but as a large population is exposed to public drinking water, the attributable risk for cardiac defects may not be negligible. (C) 2002 Elsevier Science (USA).
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| 7. |
- Cedergren, Marie, 1963-, et al.
(författare)
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Detection of fetal structural abnormalities by an 11-14-week ultrasound dating scan in an unselected Swedish population
- 2006
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 85:8, s. 912-915
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Tidskriftsartikel (refereegranskat)abstract
- Background. To determine the detection rate of fetal structural abnormalities by a routine 11-14-week ultrasound scan for dating in an unselected pregnant population. Methods. A prospective observational cohort study of 2,708 unselected pregnant women attending an abdominal ultrasound examination at 11-14 weeks gestation. The number of major fetal structural abnormalities diagnosed after birth was obtained from a computerized database at the same unit. Results. Out of 2,708 pregnant women, 89 (3.3%) were found to have a missed abortion at the time of the ultrasound scan and 33 (1.2%) were diagnosed as twins. Thirteen major structural abnormalities were detected, three cases of anencephaly (one case also had a spina bifida), one case with hydranencephaly, one fetus with Dandy-Walker syndrome, two cases with gastroschisis, one case with a bilateral hydronephrosis, one case with a generalized hydrops, one fetus with multiple malformations, and three cystic hygromas. An additional 19 major structural defects were detected at birth. Four cases of neural tube defects and nine fetuses with congenital heart defects were diagnosed. The antenatal ultrasound detection rate was 40.6% (13/32). Nine patients had a nuchal translucency greater than 3.0 mm (excluding cystic hygromas), two of them had chromosomal abnormalities (trisomy 21 and trisomy 18). Conclusions. Fetal structural abnormalities were detected in 41% (95%CI = 24-59) of the cases in an unselected pregnant population at a routine 11-14-week ultrasound scan for dating purpose. Two out of nine fetuses with a nuchal translucency greater than 3.0 mm had a chromosomal abnormality. © 2006 Taylor & Francis.
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| 8. |
- Cedergren, Marie, 1963-
(författare)
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Effects of gestational weight gain and body mass index on obstetric outcome in Sweden
- 2006
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Ingår i: International Journal of Gynecology & Obstetrics. - : Elsevier. - 0020-7292 .- 1879-3479. ; 93:3, s. 269-274
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Objective: The objective of this study was to estimate the effects of low and high gestational weight gain, in different maternal Body Mass Index (BMI) classes, on obstetric and neonatal outcomes. Method: A prospective population-based cohort study of 245,526 singleton term pregnancies. Women were grouped in five categories of BMI and in three gestational weight gain categories, < 8 kg (low weight gain), 8-16 kg and > 16 kg (high weight gain). Obstetric and neonatal outcomes were evaluated after adjustments for maternal age, parity, smoking, year of birth. Result: Obese women with low gestational weight gain had a decreased risk for the following outcomes (adjusted odds ratio, 95% confidence interval): preeclampsia (0.52, 0.42-0.62), cesarean section (0.81, 0.73-0.90), instrumental delivery (0.75, 0.63-0.88), and LGA births (0.66, 0.59-0.75). There was a 2-fold increased risk for preeclampsia and LGA infants among average and overweight women with excessive weight gain. High gestational weight gain increased the risk for cesarean delivery in all maternal BMI classes. Conclusion: The effects of high or low gestational weight gain differ depending on maternal BMI and the outcome variable studied. Obese women may benefit from a low weight gain during pregnancy.
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| 9. |
- Cedergren, Marie, 1963-
(författare)
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Epidemiological studies of congenital heart defects in the Southeast region of Sweden
- 2002
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In the most recent analysis of Swedish data on congenital malformations, it appeared that in the county of Östergötland, the prevalence of infants with a diagnosed congenital malformation was higher than in the rest of the country. This observation initiated an effort to make a more complete identification of all infants born with a congenital malformation in that county and to compare it with the other two counties in the Southeast region of Sweden (Jönköping and Kalmar), utilising all the relevant Swedish medical health registers available. A total of 10,171 infants with a congenital malformation of any type were identified in the region: 4,698 infants in Östergötland county (6.2%), and 5,473 in the reference counties (5.4%). A 15% excess malformation risk in Östergötland compared with the two reference counties. Various validations of the register data were undertaken and different types of error were detected. Limb reduction defects seemed to occur more often in Östergötland county and there was an increased risk of cardiovascular malformations in Östergötland county (22%).The next step comprised an exploration of putative risk factors for cardiac defects in the area. Maternal body mass index (BMI) >29 was found to be a significant risk factor for cardiac defects. Maternal diabetes mellitus and maternal use of antiepileptics were associated with an increased risk of cardiac defects in the offspring.To explore if the pregnant women in Östergötland county differed from the women in the reference counties, a comparative analysis of potential risk factors was performed. The only single putative risk factor that could contribute to the excess risk of cardiac defects in Östergötland county was matemal residency in a rural district. Notably, nearly all the potential risk factors studied i.e. spontaneous abortions, involuntary childlessness, maternal disease, high maternal body mass index, matemal medical during use and alcohol use in early pregnancy, parental employment and paternal age were stronger in Östergötland county compared to the reference area. A conceivable explantation is that one or more unidentified factors could activate prevalent and weak teratogenic risk factors for cardiac defects.Drinking water could be such a factor. By using a geographical infmmation system (GIS) it was possible to obtain individual data on drinking water characteristics. An increased tisk of a congenital cardiac defect seemed to be associated with the chlorination procedure, in particular the use of chlorine dioxide, and with increasing total trihalomethane concentration.
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| 10. |
- Cedergren, Marie, 1963-, et al.
(författare)
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Geographic variations in possible risk factors for severe cardiac malformations
- 2002
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Ingår i: Acta Pædiatrica. - : Wiley. - 1651-2227 .- 0803-5253. ; 91:2, s. 222-228
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate various putative risk factors in a county in Sweden, described as having a 28% increased prevalence of cardiovascular malformations, and to compare them with the risk factors in two reference counties. Women giving birth in the studied counties differed in age and parity distribution, smoking, and educational level but these differences could not explain the increased risk of cardiovascular malformations in the county, since after stratification for these variables, the risk, estimate did not change substantially. A number of potential risk factors were studied in a case/control design: spontaneous abortions, involuntary childlessness, maternal disease, body mass index, medical drug use, alcohol use, parental employment, paternal age, and urban/rural residency. No single factor could be attributed to the increased rate, with the exception of living in a rural district, Nearly all risk factors, however, were stronger in the county studied than those in the reference counties (0.02 > p > 0.01). Conclusion: The only single putative risk factor that could have contributed to the increased risk for cardiac defects described in the county Studied was maternal residency in a rural district. Notably, nearly all potential risk factors studied were stronger in the counts studied compared with those in the reference area. A conceivable explanation is that one or more unidentified factors related to rural residency could potentiate prevalent and weak teratogenic risk factors for cardiac defects.
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| 11. |
- Cedergren, Marie, et al.
(författare)
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Hyperemesis gravidarum that requires hospitalization and the use of antiemetic drugs in relation to maternal body composition
- 2008
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Ingår i: American Journal of Obstetrics and Gynecology. - : Elsevier BV. - 0002-9378 .- 1097-6868. ; 198:4
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The purpose of this study was to assess whether maternal prepregnancy body mass index was associated with the use of antiemetic drugs in early pregnancy and/or with the occurrence of hyperemesis gravidarum. STUDY DESIGN: A retrospective, population-based, cohort study. Women who delivered singleton infants (n = 749,435) from 19952003 were evaluated concerning the use of antiemetic drugs in early pregnancy (data available from 1995). Women who delivered singleton infants (n = 942,894) from 1992-2001 were evaluated concerning hospitalization because of hyperemesis gravidarum (data available until 2001). Adjusted odds ratios were determined by Mantel- Haenszel technique and were used as estimates of relative risk (RR). RESULTS: Underweight pregnant women were more likely to use antiemetic drugs (RR, 1.19, 95% CI, 1.14-1.24) and to become hospitalized for hyperemesis gravidarum (RR, 1.43, 95% CI, 1.33-1.54) compared with ideal weight women. Obese women were less likely to use antiemetic drugs (RR, 0.93, 95% CI, 0.89-0.97) and less likely to require hospitalization because of hyperemesis (RR, 0.90, 95% CI, 0.85-0.95) compared with women with an ideal body mass index. CONCLUSION: The use of antiemetic drugs and the occurrence of hyperemesis gravidarum are related to maternal body composition.
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| 12. |
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| 13. |
- Cedergren, Marie I
(författare)
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Non-elective caesarean delivery due to ineffective uterine contractility or due to obstructed labour in relation to maternal body mass index
- 2009
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Ingår i: EUROPEAN JOURNAL OF OBSTETRICS and GYNECOLOGY AND REPRODUCTIVE BIOLOGY. - : Elsevier BV. - 0301-2115. ; 145:2, s. 163-166
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To assess whether non-elective caesarean section due to obstructed labour and/or ineffective uterine contractility was associated with maternal body mass index (BMI). Study design: The prospective dataset from the Swedish Medical Birth Registry consisted of 233,887 nulliparous women with a spontaneous onset of labour categorized in six classes of pre-pregnancy BMI, who delivered in Sweden between, January 1, 1999 and December 31, 2005. The mode of delivery was classified as either vaginal or by caesarean section. The caesarean section was classified as either elective or non-elective. Adjusted risks for non-elective caesarean section due to ineffective uterine contractility, or obstructed labour or fetal distress were determined using Mantel-Haenszel technique. Results: The risk of a non-elective caesarean section due to obstructed about was not significantly associated with maternal BMI. However, ineffective uterine contractility was significantly associated with maternal BMI and the risk of non-elective caesarean delivery due to labour arrest disorders increased with increasing BMI, reaching a 4-fold increased risk among the morbidly obese women. The risk of non-elective caesarean section due to fetal distress also increased significantly with increasing maternal BMI. Conclusions: It appears that ineffective labour could be a factor leading to the increased risk of non-elective caesarean section among obese and morbidly obese women. These findings challenge obstetricians to learn more about how to manage oxytocin infusions during labour in relation to maternal BMI.
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| 14. |
- Cedergren, Mickaëlle, 1969-
(författare)
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L'écriture biblique de Strindberg : Étude textuelle des citations bibliques dans Inferno, Légendes et Jacob lutte
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Inferno constitutes a turning point in Strindberg's literary production in that scriptural quotations appear more frequently and a new style emerges. This thesis presents the characteristics of the scriptural quotations appearing in Inferno (1897) and Jacob Wrestles (a fragment following Légendes, written in French and in Swedish in 1898). Comparative, discourse, textual and intertextual approaches are used to define the place and role of scriptural quotations in this literary corpus.From a historical point of view, both novels are part of the religious history of late 19th century France, where religion played a more important role than during the scientific, rationalist era characterizing the preceding decades. Strindberg adopts a new style corresponding to the spirit of his time. The art of "quoting the Bible at random" is a rhapsodic style, which appears mainly in Strindberg’s correspondence, in his Occult Diary (writings contemporary with Inferno) and in the work of some French 19th century writers. This style originates, above all, in the occult tradition, but it is also a means of imitating the Bible and identifying with a prophetic figure.The research discussed in this dissertation has made it possible to determine, for the first time, what Bible translations are used in the two novels by Strindberg (translations by Ostervald and Martin / Roques). Five different types of rewritings of quotations were found: omissions, cutting of verses, substitutions, typographical changes and inversions. These variations were aimed at harmonising the Biblical text and the Strindbergian text, while removing contextual and theological elements that bothered the writer. The discourse analysis has concentrated on the quotations viewed as reported speech, distinguishing different ways of introducing Biblical verses in the novel. It was found that the narrator's subjectivity is present in the comments leading up to the quotations. The polyphonic character of some quotations has stressed the importance of identification play between the narrator and certain quotations characters such as Christ, Job and the psalmist.The intertextual analysis has revealed a large number of similarities in the scriptural quotations in the literary production of Strindberg, Swedenborg and French 19th century literature. It is shown that Inferno contains various quotations that appear in Occult Diary and in other writers’ works, such as those of Swedenborg, Péladan, Zola, Huysmans and Chateaubriand. Jacob Wrestles, on the other hand, does not include as many intertextual elements but instead reassembles many scriptural quotations that were underlined in the Bible translation used for this novel: La Sainte Bible, Ostervald's translation from 1890, which can be found in Blå Tornet (The Strindberg Museum in Stockholm). Strindberg is consequently recycling Biblical material when he writes Inferno, while resorting to the French Bible of Ostervald from 1890 to write Jacob Wrestles.The quotations strewn in Inferno constitute a crescendo and reveal the narrator’s unsuccessful attempt at conversion, at the same time forming the structure of a complaint psalm in which the narrator cries out his suffering and awaits liberation. In the French text of Jacob Wrestles, the writer offers a package of scriptural quotations in order to identify the narrator as "a religious man", imploring God's mercy like Moses and Job. In the Swedish text of Jacob Wrestles, a new perspective is introduced as a result of the change in language, the change from Old to New Testament, the new spiritual disposition of the narrator and the sudden intrusion of the writer in the narrator’s space. The role of scriptural quotations in the entire fragment of Jacob Wrestles is a true linguistic, thematic and theological revolution, which accounts for the narrator's extraordinary religious evolution. The misery of the narrator in Inferno allows a ray of Christian hope, which will persist in Strindbergs’s literary production post-Inferno.
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| 15. |
- Cedergren, Marie
(författare)
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Maternal morbid obesity and the risk of adverse pregnancy outcome
- 2004
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Ingår i: Obstetrics and Gynecology. - 0029-7844 .- 1873-233X. ; 103:2, s. 219-224
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate whether morbidly obese women have an increased risk of pregnancy complications and adverse perinatal outcomes. METHODS: In a prospective population-based cohort study, 3,480 women with morbid obesity, defined as a body mass index (BMI) more than 40, and 12,698 women with a BMI between 35.1 and 40 were compared with normal-weight women (BMI 19.8-26). The perinatal outcome of singletons born to women without insulin-dependent diabetes mellitus was evaluated after suitable adjustments. RESULTS: In the group of morbidly obese mothers (BMI greater than. 40) as compared with the normal-weight mothers, there was an increased risk of the following outcomes (adjusted odds ratio, 95% confidence interval): preeclampsia (4.82, 4.04, 5.74), antepartum stillbirth (2.79, 1.94,4.02), cesarean delivery (2.69, 2.49,2.90), instrumental delivery (1.34, 1.16, 1.56), shoulder dystocia (3.14, 1.86, 5.31), meconium aspiration (2.85, 1.60, 5.07), fetal distress (2.52, 2.12,2.99), early neonatal death (3.41, 2.07,5.63), and large-for-gestational age (3.82, 3.50, 4.16). The associations were similar for women with BMIs between 35.1 and 40 but to a lesser degree. CONCLUSION: Maternal morbid obesity in early pregnancy is strongly associated with a number of pregnancy complications and perinatal conditions. tricians and Gynecologists.
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| 16. |
- Cedergren, Marie, 1963-, et al.
(författare)
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Maternal obesity and infant heart defects
- 2003
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Ingår i: Obesity Research. - 1071-7323 .- 1550-8528. ; 11:9, s. 1065-1071
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This study determined whether obese women have an increased risk of cardiovascular defects in their offspring compared with average weight women. Research Methods and Procedures: In a case-control study, prospectively collected information was obtained from Swedish medical health registers. The study included 6801 women who had infants with a cardiovascular defect and, as controls, all delivered women (N = 812,457) during the study period (1992 to 2001). Infants with chromosomal anomalies or whose mothers had pre-existing diabetes were excluded. Obesity was defined as BMI >29 kg/m2, and morbid obesity was defined as BMI >35 kg/m2. Comparisons were made with average weight women (BMI = 19.8 to 26 kg/m2). Results: In the group of obese mothers, there was an increased risk for cardiovascular defects compared with the average weight mothers [adjusted odds ratio (OR) = 1.18, 95% CI, 1.09 to 1.27], which was slightly more pronounced for the severe types of cardiovascular defects (adjusted OR = 1.23, 95% CI, 1.05 to 1.44). With morbid obesity, the OR for cardiovascular defects was 1.40 (95% CI, 1.22 to 1.64), and for severe cardiovascular defects, the OR was 1.69 (95% CI, 1.27 to 2.26). There was an increased risk for all specific defects studied among the obese women, but only ventricular septal defects and atrial septal defects reached statistical significance. Discussion: In this sample, a positive association was found between maternal obesity in early pregnancy and congenital heart defects in the offspring. A suggested explanation is undetected type 2 diabetes in early pregnancy, but other explanations may exist.
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| 17. |
- Cedergren, Marie, 1963-, et al.
(författare)
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Maternal obesity and the risk for orofacial clefts in the offspring
- 2005
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Ingår i: The Cleft Palate - Craniofacial Journal. - : SAGE Publications. - 1545-1569 .- 1055-6656. ; 42:4, s. 367-371
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To estimate whether obese women have an increased risk of orofacial clefts in their offspring, compared with average-weight women. Design and Participants: The study was based on information on maternal body mass index (BMI) collected in early pregnancy and on the existence of orofacial clefts in the offspring, ascertained from multiple sources. The study included 1686 women who had infants with an orofacial cleft and as controls all delivered women (n = 988,171) during the study period, 1992 through 2001. Infants with chromosome anomalies were excluded. The women were divided into underweight (BMI < 19.8), average weight (reference group, BMI 19.8 to 26), overweight (BMI 26.1 to 29), and obese (BMI > 29). Adjustments were made for year of birth, maternal age, parity, and maternal smoking. Results: Obese (BMI >29) mothers had an overall increased risk for having an infant with orofacial clefts: odds ratio 1.30 (95% confidence interval 1.11 to 1.53). This increased risk was higher when the cleft was associated with other major malformations than when it was isolated. There was no statistically significant difference between the risk estimates for cleft lip and cleft palate. Conclusions: In this large sample, a positive association appears between maternal obesity in early pregnancy and orofacial clefts in the offspring. The explanation for this association is not known, but a relationship with undetected type 2 diabetes is one possibility.
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| 18. |
- Cedergren, Marie, 1963-, et al.
(författare)
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Obstetric outcome of 6346 pregnancies with infants affected by congenital heart defects
- 2006
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Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115 .- 1872-7654. ; 125:2, s. 211-216
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate whether pregnancies with infants affected by congenital heart defects are associated with adverse obstetric and perinatal outcome. Study design: In a prospective population-based cohort study from Sweden (1992-2001), 6346 singleton pregnancies with infants affected by congenital heart defects were, after suitable adjustments, compared to all delivered women. Results: The prevalence of cardiovascular defects was 9.1 per 1000 births. Among them, mothers of 6346 infants (71%) had information on maternal smoking habits and maternal height and weight in early pregnancy that enabled the calculation of BMI. All cases with known chromosomal abnormalities and/or maternal pre-existing diabetes were excluded. Eighty-four percent (n = 5338) had an isolated cardiovascular defect. Severe types occurred in 21.7% (n = 1378). In the group of pregnancies with infants affected by congenital heart defects as compared to all delivered women, there was an increased risk of the following outcomes (adjusted OR (95%Cl)): pre-eclampsia (1.21 (1.06-1.37)), cesarean section (1.91 (1.79-2.03)), instrurnental delivery (1.21 (1.10-1.34)), pre-term delivery (2.58 (2.39-2.79)), small-for gestational age (1.96 (1.77-2.16)), meconium aspiration (1.51 (1.28-1.77)), and fetal distress (1.38 (1.17-1.63)). Conclusions: Pregnancies with infants affected by congenital heart defects are associated with several obstetric and neonatal complications. (c) 2005 Elsevier Ireland Ltd. All rights reserved.
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| 19. |
- Cedergren, Marie, 1963-
(författare)
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Optimal gestational weight gain for body mass index categories
- 2007
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Ingår i: Obstetrics and Gynecology. - 0029-7844 .- 1873-233X. ; 110:4, s. 759-764
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To establish optimal gestational weight gain for each maternal body mass index (BMI) category based on significant risk estimates of adverse maternal and fetal outcome. METHODS: The study population consisted of 298,648 singleton pregnancies delivered in Sweden between January 1, 1994, and December 31, 2004. The number of individuals in each weight gain class was compared with the number of individuals in all other weight gain classes in the same BMI group with regard to adverse maternal and fetal outcome. Odds ratios were calculated after suitable adjustments. RESULTS: The optimal gestational weight gain in women by prepregnancy BMI was 9-22 lb (4-10 kg) for BMI less than 20, 5-22 lb (2-10 kg) for BMI 20-24.9, less than 20 lb (less than 9 kg) for BMI 25-29.9, and less than 13 lb (less than 6 kg) for BMI of 30 or more. CONCLUSION: The gestational weight gain limits for BMI categories determined in this large population-based cohort study from Swedish Medical Registers showed that a decreased risk of adverse obstetric and neonatal outcomes was associated with lower gestational weight gain limits than was earlier recommended, especially among obese women. © 2007 The American College of Obstetricians and Gynecologists.
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| 20. |
- Cedergren, Marie, 1963-, et al.
(författare)
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Risk factors for cardiovascular malformation - a study based on prospectively collected data
- 2002
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Ingår i: Scandinavian Journal of Work, Environment and Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 28:1, s. 12-17
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Tidskriftsartikel (refereegranskat)abstract
- Objectives The aim of this study was to identify risk factors for cardiovascular malformation. Methods In a case-referent study prospectively collected data were obtained from original medical records. The study included 277 woman who had infants with a severe cardiac defect, and for each case two referents (medical records study) were included. Data on parental age, maternal reproductive history, disease in early pregnancy, reported maternal use of drugs and alcohol, smoking habits, parental occupation, and maternal body mass index (BMI) were extracted. When data were available from Swedish medical health registers, a comparison was made (register study) between all infants with cardiovascular defects (2208) and all infants born (175 768). Results Maternal diabetes mellitus was associated with an increased risk for cardiovascular malformation [odds ratio (OR) 2.38, 95% confidence interval (95% CI) 1.36-4.15], as was a high BMI (> 29) (OR 1.46, 95%CI 1.12-1.90). A tendency towards an increased risk was found for involuntary childlessness, spontaneous abortion, thyroid drugs, and nonsteroid anti-inflammatory drugs. Conclusions Some known risk factors for cardiac defects (eg, maternal diabetes mellitus and the use of antiepileptics) could be identified. Other postulated risk factors could not be verified, for example, paternal age and parental occupation. The use of medicinal drugs seems not to be a major factor in the etiology of cardiac defects. It is possible, however, that there is an association with the use of nonsteroid anti-inflammatory drugs or drugs for thyroid disease. The relationship between a high BMI and cardiovascular malformation observed in this study may be explained by impaired maternal glucose tolerance.
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| 21. |
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Le Naturalisme spiritualiste en Europe : Développement et rayonnement
- 2012
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Samlingsverk (redaktörskap) (refereegranskat)abstract
- L’expression « naturalisme spiritualiste » apparaît pour la première fois dans la littérature française en 1891 sous la plume de Huysmans mais déjà, les littératures européennes avaient sonné le glas du naturalisme strict tel que le prônait Zola.Le paradoxe sis dans l’expression même de « naturalisme spiritualiste » méritait d’être démêlé et clarifié : sans nier les apports thématiques et formels du naturalisme, la fin du XIXe siècle semble faire état d’un nouveau besoin de spiritualité. Il s’agit alors de concilier méthode expérimentale, connaissance physiologique et questionnements ontologiques voire métaphysiques dans une écriture très sophistiquée où l’inspiration des arts pictural et liturgique est évidente. Le naturalisme spiritualiste viendrait donc révéler au moyen d'éléments concrets une réalité surnaturelle et réintègrerait l’âme dans le tissu littéraire pour que la vérité et la complexité du monde et de l’homme puissent enfin être révélées.Pour être le premier à avoir formalisé ce nouveau courant idéologique et littéraire, Huysmans n’est pas pour autant le seul dépositaire du concept. Cet ouvrage se propose de faire découvrir au lecteur les grandes figures littéraires qui ont marqué ce mouvement avec les nuances spirituelles et scripturales propres à leurs personnalités mais aussi à leur aire culturelle et géographique. Parmi ces hommes on rencontre D’Annunzio, Barbey d’Aurevilly, Walter Pater, August Strindberg, Leopoldo Alas Clarín, Galdós, pour n’en citer que quelques-uns…
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| 22. |
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| 23. |
- Lundgren, Cecilia, et al.
(författare)
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Ante- and intrapartum risk factors for neonatal hypoxic ischemic encephalopathy
- 2018
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Ingår i: The Journal of Maternal-Fetal & Neonatal Medicine. - : Taylor & Francis. - 1476-7058 .- 1476-4954. ; 31:12, s. 1595-1601
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Tidskriftsartikel (refereegranskat)abstract
- To identify obstetrical risk factors for the diagnosis of neonatal hypoxic ischemic encephalopathy (HIE). A secondary aim was to determine the incidence of HIE.
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| 24. |
- Nilsen, Per, 1960-, et al.
(författare)
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Alcohol use before and during pregnancy and factors influencing change among Swedish women
- 2008
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 87:7, s. 768-774
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To investigate alcohol intake during pregnancy among women, to assess health cares providers' advice to the women and the relative importance of different factors on changes in the women's drinking. Design. Questionnaire study. Setting. Linkoping, Sweden. Population. A total number of 1,533 women registered at a maternity health care center in Linkoping during a one-year period, from 1 April 2005 to 31 March 2006. Methods. Mailed anonymous questionnaire with a response rate of 61%. Main outcome measures. Drinking behavior and information sources. Results. During pregnancy, 94% (n=869) of the responding women abstained from alcohol, including 13% (n=117) who were already abstainers. Six percent (n=55) continued drinking during the pregnancy. Those who continued drinking during pregnancy were older, had more often given birth and drank more frequently before pregnancy than the women who abstained. Half of the respondents (n=428) believed that decreases in alcohol intake during pregnancy reported in previous studies could be due to inaccurate self-reporting. The main message from maternity health care providers was perceived to be complete abstinence from alcohol during pregnancy (85%, n=777), although 8% (n=76) claimed that they had not received any advice regarding this. Media attention concerning risks associated with drinking during pregnancy was seen as slightly more important to achieve reduced alcohol intake during pregnancy than advice from maternity health care providers. Conclusions. A majority of women in this study reported abstaining from alcohol during pregnancy. © 2008 Informa UK Ltd. (Informa Healthcare, Taylor & Francis AS).
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| 25. |
- Nilsen, Per, et al.
(författare)
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Is Questionnaire-Based Alcohol Counseling More Effective for Pregnant Women Than Standard Maternity Care?
- 2010
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Ingår i: JOURNAL OF WOMENS HEALTH. - : Mary Ann Liebert Inc. - 1540-9996 .- 1931-843X. ; 19:1, s. 161-167
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To compare current standard maternity care in Sweden concerning provision of alcohol advice with a more comprehensive questionnaire-based counseling model. Methods: The study population included pregnant women in Linkoping who were registered at a maternity care center during a 2-year period and whose pregnancies resulted in liveborn infants without birth defects, representing 93% of all pregnant women. Anonymous questionnaires were mailed to the women. The first cohort (registered April 2005 1, to March 31, 2006) received standard care according to a procedure that is common practice in Sweden. The second cohort (April 1, 2006 to March 31, 2007) received alcohol advice based on a comprehensive counseling model, incorporating the use of the three-item Alcohol Use Disorders Identification Test (AUDIT-C) questionnaire and tailored counseling based on the AUDIT-C score. Results: The response rate was 61% in the first cohort (standard care) and 70% in the second cohort (questionnaire-based counseling). The cohorts were similar in sociodemographic variables and prepregnancy drinking characteristics. The proportion of women who continued drinking alcohol during the pregnancy was 6.0% in cohort 1 and 5.8% in cohort 2. Women in cohort 2 were more favorable to the advice and, to a larger extent, perceived the main message to be abstinence from drinking during pregnancy. Conclusions: The questionnaire-based counseling model was more favorably perceived than the standard care model, but the new model was not more effective in terms of its impact on the proportion of women who abstained from drinking during pregnancy.
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